Oregon Spine Care LLC

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

License

MD26166 Issued in OR

Legal business name

OREGON SPINE CARE LLC

Practice address

19255 SW 65TH Ave
Suite 200
Tualatin, OR 97062-7451

Phone

(503) 828-1150

Fax

(503) 828-1160

NPI assigned

Nov 2, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Robert L Tatsumi, MD

Title

Owner

Phone

(503) 828-1150

Specialties & licenses 1

Addresses

Other names 1

• Oregon Spine Care Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alexander C Ching, MD

  • Orthopaedic Surgery Physician
  • Tualatin, OR
  • NPI 1932263845

  OR

  Medicare reassignment Care Compare group NPD
• John Mason Depasse, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Tualatin, OR
  • NPI 1134489131

  OR, Single Specialty

  Medicare reassignment Care Compare group NPD
• Nicole J Bangs, P.A.-C.

  • Surgical Physician Assistant
  • Salem, OR
  • NPI 1336242536

  OR

  Medicare reassignment Care Compare group
• Eric Nguyen, PA-C

  • Physician Assistant
  • Tualatin, OR
  • NPI 1821749466

  OR

  Medicare reassignment Care Compare group
• Amber Harshfield, PA-C

  • Physician Assistant
  • Fishersville, VA
  • NPI 1487497178

  OR

  Medicare reassignment Care Compare group
• Rachel J Seeley, PA-C

  • Physician Assistant
  • Sacramento, CA
  • NPI 1477270585

  OR

  Medicare reassignment
• Kelsey Lynn Gretzinger, PA-C

  • Physician Assistant
  • Tualatin, OR
  • NPI 1619445715
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538352000000",
    "number": "1376972182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19255 SW 65TH AVE",
            "address_2": "SUITE 200",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970627451",
            "telephone_number": "503-828-1150",
            "fax_number": "503-828-1160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19255 SW 65TH AVE",
            "address_2": "SUITE 200",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970627451",
            "telephone_number": "503-828-1150",
            "fax_number": "503-828-1160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OREGON SPINE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-02",
        "last_updated": "2018-10-01",
        "status": "A",
        "authorized_official_last_name": "TATSUMI",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-828-1150",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "OR",
            "license": "MD26166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oregon Spine Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Oregon Spine Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Kevin Keith Oyama, MD

• All providers in Tualatin, OR
• Orthopaedic Surgery of the Spine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.